What is child abuse and neglect?
What is child abuse and neglect?
Child maltreatment refers to any non-accidental behaviour by parents, caregivers, other adults or older adolescents that is outside the norms of conduct and entails a substantial risk of causing physical or emotional harm to a child or young person. Such behaviours may be intentional or unintentional and can include acts of omission (i.e., neglect) and commission (i.e., abuse) (Bromfield, 2005; Christoffel, et al., 1992). In this paper, the terms "child abuse and neglect" and "child maltreatment" are used interchangeably.
Child maltreatment is commonly divided into five main subtypes:
- physical abuse;
- emotional maltreatment;
- sexual abuse; and
- the witnessing of family violence.
Although there is a broad consensus regarding the different subtypes of maltreatment, disagreement exists about exactly how to define these subtypes. In the absence of universal definitions of child abuse and neglect, different professional fields have developed their own definitions. There are medical and clinical definitions, social service definitions, legal and judicial definitions, and research definitions of child maltreatment. Each professional sector tends to emphasise the facets of maltreatment that are most salient to their own field. For example, medical definitions highlight the physical symptoms of a child rather than the abusive or neglectful behaviours of a perpetrator, while legal and judicial definitions focus on those aspects of parental behaviour and child symptomatology that provide the best evidence for a successful prosecution (Bromfield, 2005; Feerick, Knutson, Trickett, & Flanzer, 2006).
The definitions provided in this paper are broad and research-based. They focus less on the specific harm caused to the child, and more on the abusive behaviours of the perpetrator. This approach sidesteps much of the detail and disagreement regarding the cut-off points at which specific behaviours (e.g., rejecting a child) become child maltreatment. The current definitions are too broad to be used in specific settings (such as a courtroom or child protection agency), but are detailed enough to incorporate many of the complexities involved in this area of research.
A number of complex issues need to be considered when trying to define a form of maltreatment. For example:
- Definitions of child maltreatment reflect cultural values and beliefs. Behaviour that is considered abusive in one culture may be considered acceptable in another (e.g., corporal punishment).
- Parental behaviour that is appropriate at one stage in a child's development may be inappropriate at another stage of development (e.g., the level of supervision needed for toddlers versus adolescents).
- The potential perpetrators of maltreatment need to be defined, so as not to inadvertently exclude particular behaviours and contexts. However, disagreement exists over whom should be included as potential perpetrators in the definitions of certain maltreatment subtypes (e.g., Should definitions of child sexual abuse include child and adolescent perpetrators?).
- Researchers often use categorical definitions of child maltreatment (i.e., a child is either maltreated or not maltreated). However, this approach fails to acknowledge that abusive and neglectful behaviours can differ markedly in terms of severity, the frequency and duration of occurrence, and the likelihood that they will cause physical or emotional harm.
- Child maltreatment can be defined either using abusive or neglectful adult behaviours (e.g., the definition of child physical abuse would comprise parental behaviours such as hitting or shaking), or by the harm caused to the child as a result of such behaviours (e.g., child physical abuse would be indicated if the child displayed physical symptoms such as bruising or swelling).
- Although perpetrator intent to maltreat a child is often a useful indicator of child maltreatment, there are a number of instances where abuse or neglect can occur even though the perpetrator did not intend to commit it (e.g., neglectful parents may have had no intention of neglecting their children). (Bromfield, 2005; Feerick, et al., 2006; US National Research Council, 1993)
Generally, child physical abuse refers to the non-accidental use of physical force against a child that results in harm to the child. A parent does not have to intend to physically harm their child to have physically abused them (e.g., physical punishment that results in bruising would generally be considered physical abuse). Depending on the age and the nature of the behaviour, physical force that is likely to cause physical harm to the child may also be considered abusive (e.g., a situation in which a baby is shaken but not injured would still be considered physically abusive). Physically abusive behaviours include shoving, hitting, slapping, shaking, throwing, punching, kicking biting, burning, strangling and poisoning. The fabrication or induction of an illness by a parent or carer (previously known as Munchausen syndrome by proxy) is also considered physically abusive behaviour (Bromfield, 2005; World Health Organization [WHO], 2006).
Emotional maltreatment is also sometimes called "emotional abuse", "psychological maltreatment" or "psychological abuse".
Emotional maltreatment refers to a parent or caregiver's inappropriate verbal or symbolic acts toward a child and/or a pattern of failure over time to provide a child with adequate non-physical nurture and emotional availability. Such acts of commission or omission have a high probability of damaging a child's self-esteem or social competence (Bromfield, 2005; Garbarino, Guttmann, & Seeley, 1986; WHO, 2006). According to a popular conception by Garbarino et al. (1986), emotional maltreatment takes five main behavioural forms:
- rejecting: the adult refuses to acknowledge the child's worth and the legitimacy of the child's needs;
- isolating: the adult cuts the child off from normal social experiences, prevents the child from forming friendships, and makes the child believe that he or she is alone in the world;
- terrorizing: the adult verbally assaults the child, creates a climate of fear, bullies and frightens the child, and makes the child believe that the world is capricious and hostile;
- ignoring: the adult deprives the child of essential stimulation and responsiveness, stifling emotional growth and intellectual development;
- corrupting: the adult "mis-socializes" the child, stimulates the child to engage in destructive antisocial behaviour, reinforces that deviance, and makes the child unfit for normal social experience. (p. 8)
It is worth noting that some researchers classify emotionally neglectful behaviours (e.g., rejecting, ignoring) as a form of neglect. This does not pose a problem, as long as researchers explicitly indicate under which maltreatment subtype they record such behaviours. There is certainly common conceptual ground between some types of emotional maltreatment and some types of neglect, which serves to illustrate that the different maltreatment subtypes are not always neatly demarcated (see the section in this paper on "The relationships between the different maltreatment subtypes").
Neglect refers to the failure by a parent or caregiver to provide a child (where they are in a position to do so) with the conditions that are culturally accepted as being essential for their physical and emotional development and wellbeing (Broadbent & Bentley, 1997; Bromfield, 2005; WHO, 2006). Neglectful behaviours can be divided into different sub-categories, which include:
- physical neglect: characterised by the caregiver's failure to provide basic physical necessities, such as safe, clean and adequate clothing, housing, food and health care;
- emotional (or psychological) neglect: characterised by a lack of caregiver warmth, nurturance, encouragement and support (note that emotional neglect is sometimes considered a form of emotional maltreatment);
- educational neglect: characterised by a caregiver's failure to provide appropriate educational opportunities for the child; and,
- environmental neglect: characterised by the caregiver's failure to ensure environmental safety, opportunities and resources. (Dubowitz, Pitts, & Black, 2004)
Defining sexual abuse is a complicated task. Although some behaviours are considered sexually abusive by almost everyone (e.g., the rape of a 10-year-old child by a parent), other behaviours are much more equivocal (e.g., consensual sex between a 19-year-old and a 15-year-old), and judging whether or not they constitute abuse requires a sensitive understanding of a number of definitional issues specific to child sexual abuse.
A very general definition of child sexual abuse has been proposed by Tomison (1995): "the use of a child for sexual gratification by an adult or significantly older child/adolescent" (p. 2). Similarly, Broadbent & Bentley (1997) defined child sexual abuse as: "any act which exposes a child to, or involves a child in, sexual processes beyond his or her understanding or contrary to accepted community standards" (p. 14). Sexually abusive behaviours can include the fondling of genitals, masturbation, oral sex, vaginal or anal penetration by a penis, finger or any other object, fondling of breasts, voyeurism, exhibitionism and exposing the child to or involving the child in pornography (Bromfield, 2005; US National Research Council, 1993).
However, unlike the other maltreatment types, the definition of child sexual abuse varies depending on the relationship between the victim and the perpetrator. For example, any sexual behaviour between a child and a member of their family (e.g., parent, uncle) would always be considered abusive, while sexual behaviour between two adolescents may or may not be considered abusive, depending on whether the behaviour was consensual, whether any coercion was present, or whether the relationship between the two young people was equal (Ryan, 1997). Thus, in this paper, different definitions are presented for each class of perpetrator: adults with no familial relationship to the child, adult family members of the child, adults in a position of power or authority over the child (e.g., teacher, doctor), adolescent or child perpetrators, and adolescent or child family members.
Adults with no familial relationship to the child
Any sexual behaviour between a child under the age of consent and an adult is abusive (the age of consent is 16 years in most Australian states; see Age of Consent Laws for a more detailed discussion). Therefore, in Australia, consensual sexual activity between a 20-year-old and a 15-year-old is considered abusive, while the same activity between a 20-year-old and a 17-year-old is not considered abusive.
Family members of the child
Any sexual behaviour between a child and an adult family member is abusive. The concepts of consent, equality and coercion are inapplicable in instances of intra-familial abuse.
Adults in a position of power or authority over the child
Sexual abuse occurs when there is any sexual behaviour between a child and an adult in a position of power or authority over them (e.g., a teacher). The age of consent laws are inapplicable in such instances due to the strong imbalance of power that exists between children and authority figures, as well as the breaching of both personal and public trust that occurs when professional boundaries are violated.
Adolescent or child perpetrators
Sexual abuse is indicated when there is non-consensual sexual activity between minors (e.g., a 14-year-old and an 11-year-old), or any sexual behaviour between a child and another child or adolescent who - due to their age or stage of development - is in a position of power, trust or responsibility over the victim. For example, any sexual activity between a 9-year-old and a 15-year-old would be considered abusive as the age difference between the two children leads not only to marked developmental differences, but also disparities in their levels of power and responsibility within their relationship. Another example of abuse due to an imbalance of power would be sexual activity between two 15-year-olds, where one suffers an intellectual disability that impairs their ability to understand the behaviours that they are engaging in. Normal sexual exploration between consenting adolescents at a similar developmental level is not considered abuse.
Adolescent or child family members
Sexual abuse occurs when there is sexual activity between a child and an adolescent or child family member that is non-consensual or coercive, or where there is an inequality of power or development between the two young people. Although consensual and non-coercive sexual behaviour between two developmentally similar family members is not considered child sexual abuse, it is considered incest, and is strongly proscribed both socially and legally in Australia.
Witnessing of family violence
The witnessing of family violence has been broadly defined as "a child being present (hearing or seeing) while a parent or sibling is subjected to physical abuse, sexual abuse or psychological maltreatment, or is visually exposed to the damage caused to persons or property by a family member's violent behaviour" (Higgins, 1998, p. 104). Narrower definitions refer only to children being exposed to domestic violence between intimate partners.
Some researchers classify the witnessing of family violence as a special form of emotional maltreatment. However, a growing number of professionals regard the witnessing of family violence as a unique and independent subtype of abuse (as it is presented in this paper) (e.g., Bromfield, 2005; Higgins, 2004; James, 1994). Regardless of the classification used, research has shown that children who witness domestic violence tend to experience significant disruptions in their psychosocial wellbeing, often exhibiting a similar pattern of symptoms to other abused or neglected children (Kitzmann, Gaylord, Holt, & Kenny, 2003; Tomison, 2000)
Additional forms of child maltreatment
As well as the five main subtypes of child maltreatment, researchers have identified other types, including:
- foetal abuse (i.e., behaviours by pregnant mothers that could endanger a foetus, such as the excessive use of tobacco, alcohol or illicit drugs);
- bullying, or peer abuse;
- sibling abuse;
- witnessing community violence;
- institutional abuse (i.e., abuse that occurs in institutions such as foster homes, group homes, voluntary organisations such as the Scouts, and child care centres);
- organised exploitation (e.g., child sex rings, child pornography, child prostitution); and
- state-sanctioned abuse (e.g., female genital mutilation in parts of Africa, the "Stolen Generations" in Australia). (Corby, 2006; Miller-Perrin & Perrin, 2007)
The relationships between the different maltreatment subtypes
Although it is useful to distinguish between the different subtypes of child maltreatment in order to understand and identify them more thoroughly, it can also be slightly misleading. It is misleading if it creates the impression that there are always strong lines of demarcation between the different abuse subtypes, or that abuse subtypes usually occur in isolation. There is a growing body of evidence to suggest that maltreatment subtypes seldom occur in isolation; the majority of individuals with a history of maltreatment report exposure to two or more subtypes (Arata, Langhinrichsen-Rohling, Bowers, & O'Farrill-Swails, 2005; Higgins & McCabe, 2000; Ney, Fung, & Wickett, 1994). Additionally, some acts of violence against children involve multiple maltreatment subtypes. For example, an adult who sexually abuses a child may simultaneously hit them (i.e., physical abuse) and isolate or terrorise them (e.g., emotional abuse). Similarly, when parents subject their children to sexual or physical abuse, how can the emotional harm and betrayal of trust implicit in these acts not also be thought of as a form of emotional maltreatment?
- Arata, C. M., Langhinrichsen-Rohling, J., Bowers, D., & O'Farrill-Swails, L. (2005). Single versus multi-type maltreatment: An examination of the long-term effects of child abuse. Journal of Aggression, Maltreatment & Trauma, 11(4), 29-52.
- Broadbent, A., & Bentley, R. (1997). Child abuse and neglect Australia 1995-96 (Child Welfare Series No. 17). Canberra: Australian Institute of Health and Welfare.
- Bromfield, L. M. (2005). Chronic child maltreatment in an Australian Statutory child protection sample (Unpublished doctoral dissertation). Deakin University, Geelong.
- Christoffel, K. K., Scheidt, P. C., Agran, P. F., Kraus, J. F., McLoughlin, E., & Paulson, J. A. (1992). Standard definitions for childhood injury research: Excerpts of a conference report. Pediatrics, 89(6), 1027-1034.
- Corby, B. (2006). Child abuse: Towards a knowledge base (3rd ed.). Berkshire, England: Open University Press.
- Dubowitz, H., Pitts, S. C., & Black, M. M. (2004). Measurement of three major subtypes of child neglect. Child Maltreatment, 9(4), 344-356.
- Feerick, M. M., Knutson, J. F., Trickett, P. K., & Flanzer, S. M. (2006). Child abuse and neglect: Definitions, classification, & a framework for research. Baltimore, MD: Paul H. Brooks Publishing Company.
- Garbarino, J., Guttmann, E., & Seeley, J. W. (1986). The psychologically battered child: Strategies for identification, assessment, and intervention. San Francisco, California: Jossey-Bass Inc.
- Higgins, D. J. (1998). Multi-type maltreatment: Relationships between familial characteristics, maltreatment and adjustment of children and adults (Unpublished doctoral dissertation). Deakin University, Burwood.
- Higgins, D. J. (2004). Differentiating between child maltreatment experiences. Family Matters, 69, 50-55.
- Higgins, D. J., & McCabe, M. P. (2000). Relationships between different types of maltreatment during childhood and adjustment in adulthood. Child Maltreatment, 5, 261-272.
- James, M. (1994). Domestic violence as a form of child abuse: Identification and prevention. Melbourne: National Child Protection Clearinghouse.
- Kitzmann, K. M., Gaylord, N. K., Holt, A. R., & Kenny, E. D. (2003). Child witnesses to domestic violence: A meta-analytic review. Journal of Consulting and Clinical Psychology, 71(2), 339-352.
- Miller-Perrin, C. L., & Perrin, R. D. (2007). Child maltreatment: An introduction. Thousand Oaks, CA: Sage Publications.
- Ney, P. G., Fung, T., & Wickett, A. R. (1994). The worst combinations of child abuse and neglect. Child Abuse & Neglect, 18(9), 705-714.
- Ryan, G. (1997). Sexually abusive youth: Defining the population. In G. Ryan & S. Lane (Eds.), Juvenile sexual offending: Causes, consequences, and correction (pp. 3-9). San Francisco: Jossey-Bass.
- Tomison, A. M. (1995). Update on child sexual abuse (Issues Paper No. 5). Melbourne: National Child Protection Clearinghouse.
- Tomison, A. M. (2000). Exploring family violence: Links between child maltreatment and domestic violence (Issues Paper No. 13). Melbourne: National Child Protection Clearinghouse.
- US National Research Council. (1993). Understanding child abuse and neglect. Washington, D.C.: National Academy Press.
- World Health Organization. (2006). Preventing child maltreatment: A guide to taking action and generating evidence. Geneva: WHO.
This paper was prepared by Rhys Price-Robertson, Senior Research Officer with the Child Family Community Australia information exchange at the Australian Institute of Family Studies. The content is current as of June 2012.
Previous editions have been compiled by Rhys Price-Robertson, Leah Bromfield and Nick Richardson.
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